Get the free Sutent® (sunitinib) Prior Authorization of Benefits (PAB) Form

This form is used to request prior authorization for the medication Sutent® (sunitinib) for patients with specific diagnoses, ensuring that the prescribing physician provides all necessary patient

How to fill out sutent sunitinib prior authorization

How to fill out Sutent® (sunitinib) Prior Authorization of Benefits (PAB) Form

1. Obtain a blank Sutent® Prior Authorization of Benefits (PAB) Form from the pharmacy or healthcare provider.
2. Complete the patient information section, including the patient's name, date of birth, and insurance details.
3. Fill out the prescribing physician's information, including name, contact number, and address.
4. Provide the relevant medical information that justifies the need for Sutent®, such as diagnosis and treatment history.
5. Specify the dosage and frequency of Sutent® prescribed by the physician.
6. Attach any supporting documentation, such as lab results or previous treatment records.
7. Review the completed form for accuracy and completeness.
8. Submit the form to the insurance company or healthcare provider designated for prior authorization.
9. Follow up with the insurance company to confirm receipt and approval status of the prior authorization.

Who needs Sutent® (sunitinib) Prior Authorization of Benefits (PAB) Form?

1. Patients who are prescribed Sutent® (sunitinib) for the treatment of certain cancers.
2. Healthcare providers who need to ensure insurance coverage for Sutent® before treatment begins.
3. Pharmacists who need to verify prior authorization before dispensing Sutent®.

People Also Ask about

How much does sunitinib cost?

Get Sunitinib for as low as $3,982.95, which is 88% off the average retail price of $33,872.08 for the most common version, by using a GoodRx coupon.

Can sunitinib affect the kidneys?

The incidences of renal insufficiency and proteinuria associated with sunitinib were 7.7% and 18.9%, respectively. 2. Patients with hypertension, dyslipidemia, chronic kidney disease, and older age were more vulnerable to sunitinib-induced renal adverse effects.

Is sunitinib generic?

Sunitinib was the first cancer drug simultaneously approved for two different indications. As of August 2021, sunitinib is available as a generic medicine in the US.

Is sunitinib available as a generic?

Sunitinib was the first cancer drug simultaneously approved for two different indications. As of August 2021, sunitinib is available as a generic medicine in the US.

Is SUTENT chemotherapy or immunotherapy?

However, it is not considered chemotherapy. Sutent is a targeted treatment, which means it targets specific proteins that contribute to the growth of cancer cells.

What is the brand name for sunitinib?

SUTENT® (sunitinib malate)

What is SUTENT used for?

SUTENT is used to treat a rare cancer of the stomach, , or esophagus called gastrointestinal stromal tumor (GIST) and when you have taken the medicine mesylate ( ®) and it did not stop the cancer from growing or you cannot take mesylate ( ®).

For pdfFiller’s FAQs

What is Sutent® (sunitinib) Prior Authorization of Benefits (PAB) Form?

The Sutent® (sunitinib) Prior Authorization of Benefits (PAB) Form is a document required by insurance companies to determine if a patient is eligible for coverage of Sutent® prior to its prescription and administration.

Who is required to file Sutent® (sunitinib) Prior Authorization of Benefits (PAB) Form?

Healthcare providers, typically physicians or authorized medical staff, are required to file the Sutent® (sunitinib) Prior Authorization of Benefits (PAB) Form on behalf of their patients.

How to fill out Sutent® (sunitinib) Prior Authorization of Benefits (PAB) Form?

To fill out the Sutent® (sunitinib) Prior Authorization of Benefits (PAB) Form, the provider should complete each section with the patient's information, medical history, dosage details, and any supporting documentation that specifies the medical necessity for the treatment.

What is the purpose of Sutent® (sunitinib) Prior Authorization of Benefits (PAB) Form?

The purpose of the Sutent® (sunitinib) Prior Authorization of Benefits (PAB) Form is to help healthcare providers obtain approval from insurance companies for coverage of the medication, ensuring that it is medically necessary and appropriate for the patient's condition.

What information must be reported on Sutent® (sunitinib) Prior Authorization of Benefits (PAB) Form?

Information that must be reported on the Sutent® (sunitinib) Prior Authorization of Benefits (PAB) Form includes patient demographics, medical diagnosis, treatment history, requested dosage of the medication, and rationale for the use of Sutent®.